There is a compelling need for varied trauma specific treatment models for children and adolescents with complex trauma in residential treatment whose affect and behavioral dysregulation disrupts daily living and impedes treatment engagement. This conceptual paper introduces exploratory applications of sensory motor approaches to the treatment of affect and behavioral dysregulation. Sensory Integration, a specialization within occupational therapy Ayres 1972, 2004 provides knowledge of the sensory motor systems and strategies for sensory modulation that addresses arousal regulation, which underlies this dysregulation. The article describes three clinically supported approaches to the use of sensory modulation in residential treatment sites: use of sensory rooms; use of sensory integration occupational therapists at residential treatment sites; and a trauma psychotherapy that utilizes sensory motor strategies to improve regulation and support trauma processing. Abstract published by arrangement with Springer.